The Southeastern Kidney Transplant (SEKTx) Coalition is an academic-community collaboration between partners in the kidney disease community who share the common goal of eliminating health disparities in access to kidney transplantation (KTx) among African American End Stage Renal Disease (ESRD) living in Georgia, North Carolina, and South Carolina. Volunteer members of this community-based coalition include ESRD and transplant patients, dialysis facility staff and providers, transplant centers, quality improvement organizations, and patient advocacy organizations. The burden of CKD and ESRD is highest in the Southeast, and yet the rate of KTx is the lowest in the nation. Further, our research suggests that racial disparities in access to KTx are concentrated in the Southeast, where African Americans (AA) are less likely to access each step in the KTx process. The long-term goal of the SEKTx Coalition is to use community- based participatory research approaches to develop, test, and disseminate sustainable, community interventions improve access to KTx for AA ESRD patients. In this planning grant, our specific aims are: Specific Aim 1. To determine the patient-, dialysis facility-, and neighborhood-level barriers to KTx in ESRD Network 6. Specific Aim 2: To develop a multilevel intervention to reduce racial disparities in access to KTx. Specific Aim 3: To determine the feasibility and effectiveness of a pilot intervention to reduce disparities in' KTx access in GA. The long-term impact of this application will be to reduce racial disparities in the kidney disease community. RELEVANCE: The burden of CKD and ESRD is highest in the Southeast, and yet the rate of KTx is the lowest in the nation. The proposed study seeks to leverage an existing academic-community collaboration with the Southeastern Kidney Transplant Coalition to identify barriers to KTx and to plan, implement, and evaluate a multilevel intervention targeting ESRD patients and dialysis facility staff.